Options after vaginal closure

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Dear OncoLink "Ask The Experts," My mother-in-law had a radical hysterectomy seven years ago. Her doctor advised her do a vaginal closure to decrease the chances of infection or recurrence. She has been cancer free for seven years but she doesn't want to form relationships with men because she cannot have intercourse. I told her I would research her option. Can she have some type of reconstructive vaginoplasty? Does she have any options?

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

After radical hysterectomy, the vagina may sometimes be shortened significantly. Depending on the amount of vaginal length left, patients who are still interested in sexual intercourse have a couple of options. Vaginal tissue may stretch over time, and either intercourse, or the conscientious use of graduated vaginal dilators may encourage enough stretch to allow for comfortable sexual relations. True "vaginal closures" are rare. In instances where the entire vagina is removed, surgery may be performed to reconstruct a new vagina from skin or muscle grafts. Some gynecologic oncologists and plastic surgeons are familiar with the technique, and I would advise consulting with one in your area if the use of vaginal dilators is not an option.